Palavras-chave
Irrigantes do canal radicular
Hipoclorito de sódio
Como Citar
Copyright © | Todos os direitos reservados.
A revista detém os direitos autorais exclusivos de publicação deste artigo nos termos da lei 9610/98.
Reprodução parcial
É livre o uso de partes do texto, figuras e questionário do artigo, sendo obrigatória a citação dos autores e revista.
Reprodução total
É expressamente proibida, devendo ser autorizada pela revista.
Resumo
Objetivos: Analisar sobre as principais soluções irrigadoras utilizadas na endodontia, considerando sua eficácia antimicrobiana, biocompatibilidade e os efeitos sobre a estrutura dentinária, a fim de subsidiar a tomada de decisão clínica baseada em evidências. Métodos: Trata-se de uma revisão integrativa da literatura, conduzida conforme as diretrizes PRISMA, com buscas nas bases PubMed, Medline e Science Direct. Foram incluídos estudos publicados entre 2014 e 2024, nos idiomas português e inglês, abrangendo metanálises, ensaios clínicos randomizados e revisões sistemáticas. Após a aplicação dos critérios de inclusão e exclusão, 31 estudos foram selecionados para análise qualitativa. Resultados: O hipoclorito de sódio apresentou elevada eficácia antimicrobiana, porém associado à redução da microdureza dentinária. O Ácido Etilenodiaminotetracético e o ácido cítrico demonstraram eficiência na remoção da smear layer. Irrigantes alternativos, como nanopartículas de prata e extratos naturais, incluindo quitosana e moringa, mostraram resultados promissores quanto à ação antimicrobiana e biocompatibilidade, embora ainda necessitem de maior respaldo científico. Considerações finais: Não existe uma solução irrigadora ideal. A combinação racional de agentes, especialmente Hipoclorito de Sódio e Ácido Etilenodiaminotetracético, associada a substâncias biocompatíveis, representa uma estratégia adequada para otimizar a desinfecção, preservar a dentina e favorecer melhores desfechos endodônticos.
Referências
AGARWAL S, et al. Effect of different irrigating solutions on root canal dentin microhardness—A systematic review with meta-analysis. Journal of Functional Biomaterials, 2024; 15(5): eXXXX.
SCHALLENBERGER M, et al. A importância das soluções irrigadoras na endodontia: uma revisão de literatura. Revista FT, v. 29, n. 141, dez. 2024.
ALJIFA M, et al. Quality of life and satisfaction outcomes of endodontic treatment. Journal of Healthcare Sciences, 2022; 2(5): 79-84.
ARAUJO HC, et al. Antimicrobial, antibiofilm and cytotoxic effects of a colloidal nanocarrier composed by chitosan-coated iron oxide nanoparticles loaded with chlorhexidine. Journal of Dentistry, 2020; 101: 103453.
BHANDI S, et al. Antimicrobial efficacy of silver nanoparticles as root canal irrigants: A systematic review. Journal of Clinical Medicine, 2021; 10(5): 1-15.
DAOOD U, et al. Antibacterial and antibiofilm efficacy of K21-E in root canal disinfection. Dental Materials, 2021; 37(10): 1511-1528.
DARRAG AM. Effectiveness of different final irrigation solutions on smear layer removal in intraradicular dentin. Tanta Dental Journal, 2014; 11(2): 93-99.
DEMENECH LS, et al. Biocompatibility of the 8.25% sodium hypochlorite irrigant solution in endodontics: An in vivo study. Microscopy Research and Technique, 2021; 84(7): 1506-1512.
DIOGUARDI M, et al. Endodontic irrigants: Different methods to improve efficacy and related problems. European Journal of Dentistry, 2018; 12(3): 459-466.
DUBEY S, et al. Comparative antimicrobial efficacy of selected root canal irrigants on commonly isolated microorganisms in endodontic infection. European Journal of Dentistry, 2017; 11(1): 12-16.
ELFARRAJ H, et al. Effects of endodontic root canal irrigants on tooth dentin revealed by infrared spectroscopy: A systematic literature review. Dental Materials, 2024; 40(8): 1021-1032.
ELKHASHAB RAM, et al. Comparison of antibacterial effect and smear layer removal of herbal versus traditional irrigants – An in vitro study. Future Dental Journal, 2018; 4(2): 165-169.
FARHIN K, et al. Reduction in bacterial loading using MTAD as an irrigant in pulpectomized primary teeth. Journal of Clinical Pediatric Dentistry, 2015; 39(2): 100-104.
GLYNIS A, et al. Regenerative endodontic procedures for the treatment of necrotic mature teeth with apical periodontitis: A systematic review and meta-analysis of randomized controlled trials. Journal of Endodontics, 2021; 47(6): 873-882.
GOKTURK H, et al. Effect of different chelating agents and their surface tension on the amount of apically extruded debris. Journal of Dental Sciences, 2021; 16(1): 195-200.
GONÇALVES LS, et al. The effect of sodium hypochlorite and chlorhexidine as irrigant solutions for root canal disinfection: A systematic review of clinical trials. Journal of Endodontics, 2016; 42(4): 527-532.
GÜÇLÜER Ö, et al. Human pulp tissue dissolution ability of different extracts of Sapindusmukorossi: An in vitro study. Chinese Herbal Medicines, 2020; 12(2): 178-182.
HAAPASALO M, et al. Irrigation in endodontics. British Dental Journal, 2014; 216(6): 299-303.
HERRERA SAUCEDO A, et al. Comparison of OxOral® and NaOClirrigants efficiency in Enterococcus faecalis elimination. Revista Odontológica Mexicana, 2017; 21(4): e233-e236.
HUTTON B, et al. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions. Annals of Internal Medicine, 2015; 162(11): 777-784.
KANDIL HE, et al. Effect of different irrigant solutions on microhardness and smear layer removal of root canal dentin. Tanta Dental Journal, 2014; 11(1): 1-11.
KHANGWAL M, et al. Effectiveness of chitosan nanoparticles and novel chemical irrigants with surfactant on smear layer removal and microhardness alteration. Journal of Oral Biology and Craniofacial Research, 2024; 14(5): 578-584.
LOCKWOOD C, et al. Practical guidance for knowledge synthesis: Scoping review methods. Asian Nursing Research, 2019; 13(5): 287-294.
MARÍ-BEFFA M, et al. Regenerative endodontic procedures: A perspective from stem cell niche biology. Journal of Endodontics, 2017; 43(1): 52-62.
MARU V, et al. Evaluation of cytotoxicity of 3.8% SDF and BioAKT solutions on the viability of dental pulp stem cells. Journal of Oral Biology and Craniofacial Research, 2024; 14(1): 86-91.
MARU VP, et al. Reduction in bacterial loading using papacarie and carisolv as an irrigant in pulpectomized primary molars. Journal of Clinical Pediatric Dentistry, 2020; 44(3): 174-179.
GOMES B, et al. Irrigating solutions and activation systems in endodontics: evidence and deficiencies. Journal of Endodontics, v. 49, n. 10, p. 1235–1247, 2023.
MUKUNDAN D, et al. Comparative evaluation of the efficacy of 1% and 3% sodium hypochlorite in reducing microbial counts in primary teeth root canals. Saudi Dental Journal, 2024; 36(8): 1123-1127.
NATSIR N, et al. Antibacterial and smear layer removal efficacy of moringa (Moringa oleifera): An in vitro study. Journal of Taibah University Medical Sciences, 2023; 18(6): 1493-1499.
NAVARRETE N, et al. Effect of the controlled delivery of chelating agents on the pulp tissue dissolution ability of fresh sodium hypochlorite solutions. Journal of Endodontics, 2023; 49(3): 307-312.
ÖZLEK E, et al. Histological evaluation of the debris removal efficiency of activation of sodium hypochlorite solution at different concentrations. BMC Oral Health, 2023; 23(1): 1-9.
PARCHAMI K, et al.Impact of endodontic irrigant solutions on the viability of stem cells from apical papilla: A systematic review. Saudi Dental Journal, 2024; 36(9): 1254-1262.
PHOTHICHAILERT S, et al. Effects of ethylenediaminetetraacetic acid on stem cells from the apical papilla. Journal of Dental Sciences, 2023; 18(1): 50-56.
RUKSAKIET K, et al. Antimicrobial efficacy of chlorhexidine and sodium hypochlorite in root canal disinfection: A systematic review and meta-analysis. Journal of Endodontics, 2020; 46(8): 1032-1041.
SHABBIR J, et al. Antimicrobial efficacy of silver diamine fluoride against Enterococcus faecalis: A systematic review of in vitro studies. BioMed Research International, 2022; 2022: 1-10.
TANVIR Z, et al. Comparative evaluation of antimicrobial efficacy of nanosilver solution, Azadirachta indica, sodium hypochlorite, and normal saline as root canal irrigants in primary teeth. Journal of the Indian Society of Pedodontics and Preventive Dentistry, 2023; 41(1): 76-82.
TAVARES S, et al. Effect of different root canal irrigant solutions on the release of dentin-growth factors: A systematic review and meta-analysis. Materials, 2021; 14(19): 1-15.
TRAUTMANN E, et al. Hydrogen peroxide versus sodium hypochlorite: All a matter of pH? Journal of Endodontics, 2021; 47(2): 297-302.
TSAI CF, et al. In vitro cytotoxicity and antibacterial activity of hypochlorous acid antimicrobial agent. Journal of Dental Sciences, 2024; 19(1): 345-356.
VIOLICH DR, CHANDLER NP. The smear layer in endodontics – A review. International Endodontic Journal, 2010; 43(1): 2-15.